OrganizationActive
Whitewater Oral Surgery Group PLLC
NPI 1104248053 · Oral and Maxillofacial Surgery (Dentist) · Boise, ID
Provider details
- NPI number
- 1104248053
- Entity type
- Organization
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Authorized official
- Kevin Kempers, Owner
- License
- M7750 (ID)
Practice location
3003 W Main St Ste 130
Boise, ID 83702-2026
Phone: (208) 342-7610
Fax: (208) 344-1799
Mailing address
3003 W Main St Ste 130
Boise, ID 83702-2026
Registry dates
- Enumerated
- 2014-01-13
- Last updated
- 2020-09-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.